Urologiia最新文献

The purpose of our work was to assess the possibility of predicting the risks of postoperative complications in patients with urolithiasis in a urological hospital.

Materials and methods: We performed a retrospective comparative study. We analyzed the medical records of patients in the department of urology of hospital clinics of Siberian State Medical University from November 2022 to May 2023. A total of 48 records of patients who had a verified diagnosis of urolithiasis were selected. Inclusion criteria were the presence of stones in the kidney or ureter and surgical intervention during the current hospitalization. Exclusion criteria included bladder stones. All patients underwent surgery for urolithiasis. The laboratory range of studies included a general urine test before surgery, bacteriological examination of urine for microflora and sensitivity to antibacterial drugs before surgery, as well as bacteriological examination of stone obtained intraoperatively. Risk factors for antibiotic resistance were also assessed.

Results: Of the 48 patients included in the study, urine and stone cultures did not reveal microflora growth in 26 (54.2%) patients. In the remaining 22 patients, we received different results: 1. only positive urine culture in 9 (18.8%) patients 2. only positive stone culture in 5 (10.4%) people 3. combination of positive bacteriological examination of urine and stone in 8 (16.7%) patients. Looking separately at 22 patients who had a positive urine or stone culture, or a combination of both, we noted that the combination of a positive urine culture with a positive stone culture and the combination of a positive urine culture with a negative stone culture were not significantly different and occurred in 36.4% and 40 .9% of cases, respectively, i.e. with a positive urine culture, there is an equal probability of about 40% of both an infected stone and a sterile one, while with a negative urine culture, an infected stone can occur in 22.7% of cases. In the early postoperative period, infectious complications were recorded in 3 (6.25%) patients. Complications were observed in 2 patients on the 4th day after surgery, and in one patient on the 2nd day. All three cases were postoperative pyelonephritis.

Conclusions: Our small study demonstrated the importance of culture in planning surgical treatment for urolithiasis. And further study of bacteriological studies of urine before surgery, urine obtained from the renal pelvis intraoperatively, and stones represents new directions for creating algorithms for monitoring patients with urolithiasis, predicting complications in the postoperative period, as well as local protocols for perioperative antibiotic prophylaxis and antibacterial therapy for patients with urolithiasis.

Introduction: Despite all the achievements of modern medicine, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains a difficult disorder to treat. Patients are often dissatisfied with the treatment outcomes, since the main symptoms, namely pain and urination disorders, usually decrease, but do not completely resolve.

Aim: To study the efficiency of the combined drug Prostatex Plus in the treatment of patients with CPPS (IIIb).

Material and methods: A total of 60 patients with chronic abacterial prostatitis of category IIIb with a severe pain were included in the study. The main group included 37 patients, who received one suppository Prostatex Plus per rectum at night for 20 days. In the control group (n=23), patients received non-steroidal anti-inflammatory drugs and vitamins. The examination was performed at baseline, on the 20th day (upon completion of the Prostatex Plus therapy) to assess the immediate effect and 30 days after completion of cytokine therapy to assess the long-term results.

Results: The average age of patients was 48.3+/-3.7 years. The duration of the disease ranged from 2 to 16 years, averaging 9.7+/-3.2 years. The leading symptom was pain in 100% of patients, the pain intensity was higher than 8 points. For all the assessed parameters, more significant positive results were obtained in the Prostatex Plus group, the effect of the treatment lasted for a month.

Conclusion: The combined use of tamsulosin and organ-specific regulatory in patients with CP/CPPS with severe pain syndrome led to a stable effect. A significant decrease in pain intensity and the total score on the CP symptom scale was seen, as well as an improvement in local microcirculation, sexual function, an increase in the maximum and average urine flow rate compared to the control group. Satisfactory treatment outcomes led to an improvement in the quality of life.

Introduction: An inguinal hernia is frequently identified in men with prostate cancer, which is likely due to similar risk factors, including age, gender and smoking.

Aim: To assess the safety and feasibility of performing concomitant robotic-assisted radical prostatectomy (RARP) and robotic-assisted transabdominal preperitoneal (TAPP) inguinal hernia repair.

Materials and methods: We retrospectively analyzed the treatment outcomes of 23 patients who underwent RARP between January 2022 and June 2023. All patients underwent RARP and robotic-assisted TAAP inguinal hernia repair using a polypropylene mesh implant.

Results: The mean age was 70 years. Median prostate volume and preoperative prostate-specific antigen (PSA) were 52 ml and 8.0 ng/ml, respectively. In all cases the procedure was successful. The mean total duration of RARP and inguinal hernia repair was 147.17 and 26.01 minutes, respectively. The mean estimated blood loss and length of hospital stay was 171.96 mL and 7 days, respectively. In nine cases there was Clavien-Dindo grade 1 complications in the postoperative period; all complications were resolved conservatively. At a median follow-up of 12 months, there were no cases of mesh infection, seroma formation, or inguinal pain.

Conclusions: Our results confirm the safety and feasibility of simultaneous RARP and robot-assisted TAPP inguinal hernia repair.

The presence of foreign bodies in the lower urinary tract has always been an interesting topic. From time to time, every urologist encounters such patients in their practice. A large number of such observations are described in the literature. A clinical case of foreign bodies in the lower urinary tract in 9 children admitted from January 2020 to December 2023 to the Department of pediatric urology of the Chelyabinsk Regional Children's Clinical Hospital are presented in the article. The patients charts were analyzed retrospectively. The methods of introducing foreign bodies into the lower urinary tract, diagnostic pathway, as well as the treatment tactics were studied.

This article presents our experience of performing a new laparoscopic method of radical orchiectomy. At the JSC "European Medical Center" in the period from 2022 to 2024 we performed laparoscopic radical orchiectomies in three patients with testicular cancer. All patients were examined on an outpatient basis, ultrasound and MRI of the scrotum, PET-CT scan were performed, and laboratory tests were carried out. Malignant testicular lesion was confirmed in all patients. All operations were performed in full volume, without complications during the operation and in the postoperative period. The duration of the laparoscopic surgery was comparable to the standard open technique. In the postoperative period the pain intensity in the area of surgery, the recovery period and the presence of complications were evaluated. CONCLUSION: Radical orchiectomy with laparoscopic assistance is a minimally invasive method of surgical treatment of testicular tumors, which allows to perform the removal of the testis and elements of the spermatic cord as radically and safely as possible, and also has pronounced advantages in the form of reduction of postoperative pain syndrome in the area of surgery (no more than 2 points on VAS), reduction of the recovery period and the risk of possible postoperative complications.

Introduction: The problem of male infertility is multifactorial. However, in recent years, the involvement of viruses, in particular human papillomaviruses (HPV), in the development of this condition has been actively discussed.

Purpose of the study: to study the effect of HPV in mono and mixed versions on ejaculate parameters.

Materials and methods: We analyzed the results of a survey of 105 patients aged from 22 to 40 years (average age - 32.3+/-6.4) with a diagnosis of infertility and pathospermia combined with PVI, with the absence of other risk factors.

Results: The presence of several viruses in the ejaculate increased the degree of biochemical and cytopathomorphological disorders of sperm recorded in patients with HPV-associated infertility.

Conclusions: a combination of several types of virus leads to a deterioration in the functional activity of Leydig and Sertoli cells of the testicles, characterized by a decrease in the synthesis of total testosterone levels and the development of qualitative and quantitative disorders of the ejaculate. This circumstance is due to the fact that with the association of several microorganisms, there is most likely an increase in the pathogenic potential of HPV.

Background and objectives: Dyslipidemia is prevalent among patients with chronic kidney disease on maintenance hemodialysis. A high LDL is a known indicator of major adverse cardiovascular outcomes, but levels may be affected by malnutrition. A high TG/HDL ratio is another indicator of hard cardiovascular outcomes that should be sought carefully.

Patients and methods: This was a cross-sectional study conducted on 111 patients on maintenance hemodialysis attending the hemodialysis unit at Basrah Nephrology and Transplantation Center at Al-Sader Teaching Hospital from September 1, 2022, to March 1, 2023. A high LDL is defined as > 60 mg/dl, and a high TG/HDL ratio is defined as >2.

Results: Among 111 patients with CKD on maintenance hemodialysis, high LDL was prevalent in 59.1%, and high TG/HDL ratio in 64.5%. Their mean ages were 52.6+/-15.7 years, 51.4% were males, and their BMIs were 25.2+/-5.6. Thirty-nine patients (35.1%) were on Aspirin (ASA), 49 patients (44.1%) were on Statins, eight patients (7.2%) were on Fibrate, and 11 patients (9.9%) were on Omega-3 fatty acids. No correlations were found between serum LDL and serum TG/HDL ratio with clinical and laboratory characteristics. A non-linear correlation between serum LDL and TG/HDL ratio was reported.

Conclusions: A high TG/HDL ratio should be sought and addressed carefully among patients with CKD on maintenance hemodialysis, as low LDL may be misleading in those populations.

Introduction: The review is devoted to the study of modern aspects of the pathogenesis, diagnosis and treatment of asymptomatic bacteriuria (AB). The search was conducted using the Medline, PubMed, EMBASE databases. The literature search data indicate that AB in pregnant women is currently an actively discussed section of modern uroinfection. Currently, there is no consensus on the pathogenetic basis, the need and choice of antimicrobial therapy for AB in pregnant women.

Purpose of the study: Generalization and analysis of world literature data on asymptomatic bacteriuria in pregnant women, study of the feasibility and validity of antibacterial treatment for this treatment.

Conclusions: AB in pregnant women, a physiological, non-pathological state of the body, previous principles of diagnosis and treatment of this condition, are outdated in the context of the development of new diagnostic methods and understanding of the pathogenesis of urinary tract diseases, and do not require the appointment of antibacterial therapy.